Ependymomas of the spinal cord

Area of Science:

• Neurosurgery
• Radiation Oncology
• Oncology

Background:

• Spinal cord ependymomas (SCE) are tumors requiring effective treatment.
• Post-operative radiation therapy (PORT) is often used for SCE, but optimal dosing is debated.
• Existing literature shows variability in prescribed PORT doses for SCE.

Purpose of the Study:

• To evaluate the efficacy and safety of a consistent high-dose PORT regimen for adult spinal cord ependymomas.
• To determine if a specific dose range of radiation can achieve local tumor control without significant morbidity.

Main Methods:

• Retrospective analysis of nine consecutive adult patients with SCE treated at Yale-New Haven Hospital.
• Consistent administration of total doses ranging from approximately 4500 to 5000 rad.
• Daily fractionated doses of 180 to 200 rad were delivered over 4.5 to 6 weeks.

Main Results:

• All nine patients received the planned high-dose radiation therapy consistently.
• Minimal acute and chronic treatment-related morbidity was observed.
• No local recurrence was documented in any patient during the follow-up period (8 months to 8 years).

Conclusions:

• A consistent post-operative radiation therapy dose of 4500-5000 rad is effective in achieving local control for spinal cord ependymomas.
• This high-dose regimen appears safe, with minimal associated morbidity in adult patients.
• The findings support the use of higher, consistent radiation doses in the management of SCE.